0001722397-19-000003.txt : 20190503 0001722397-19-000003.hdr.sgml : 20190503 20190503170507 ACCESSION NUMBER: 0001722397-19-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190503 DATE AS OF CHANGE: 20190503 EFFECTIVENESS DATE: 20190503 FILER: COMPANY DATA: COMPANY CONFORMED NAME: STAQ Pharma, Inc. CENTRAL INDEX KEY: 0001722397 IRS NUMBER: 364670631 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-338821 FILM NUMBER: 19797116 BUSINESS ADDRESS: STREET 1: 14135 E. 42ND AVE. STREET 2: UNIT 50 CITY: AURORA STATE: CO ZIP: 80239 BUSINESS PHONE: 720-961-2720 MAIL ADDRESS: STREET 1: 14135 E. 42ND AVE. STREET 2: UNIT 50 CITY: AURORA STATE: CO ZIP: 80239 FORMER COMPANY: FORMER CONFORMED NAME: QualMed Pharmacy, Inc. DATE OF NAME CHANGE: 20171113 D 1 primary_doc.xml X0708 D LIVE 0001722397 STAQ Pharma, Inc. 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 720-961-2720 COLORADO QualMed Pharmacy, Inc. Corporation true JOSEPH W BAGAN 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 Executive Officer Director JEFFREY L HVAL 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 Executive Officer Director MARK M SPIECKER 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 Executive Officer Director DAN SEFF 14135 E. 42ND AVE. Unit 50 DENVER CO COLORADO 80239 Director JERROD MILTON 14135 E. 42ND AVE. Unit 50 DENVER CO COLORADO 80239 Director DONNA LYNNE 14135 E. 42ND AVE. UNIT 50 DENVER CO COLORADO 80239 Director Pharmaceuticals Decline to Disclose 06b false 2019-04-22 false true false 5000 4000000 2000000 2000000 false 17 0 0 0 false STAQ Pharma, Inc. JOSEPH W. BAGAN JOSEPH W. BAGAN CHIEF EXECUTIVE OFFICER 2019-05-03